The 1864 yellow fever epidemic in New Bern was exacerbated through ignorance and a reluctance to spread panic amongst the civilian population. The first signs of sickness were originally attributed to other diseases and efforts to contain the 'miasma' believed to cause the illness failed. Once the epidemic was contained through evacuation, a Confederate plot to initiate germ warfare was discovered. This led some to believe Dr. Luke Blackburn used contaminated clothing to start the sickness, but it is very unlikely that was the case.

During the Civil War, Confederate attempts to build ironclads in Wilmington failed because of shortages in skilled labor and materials needed for construction. The Wilmington facilities were more than acceptable for ironclad construction but shortages in oakum, seasoned timber, and metal plate as well as the necessary woodworkers and metalworkers, doomed Confederate efforts.